Kristiansen Mona Kjærbøl, Bak-Fredslund Kirstine Petrea, Kramer Stine, Villadsen Gerda Elisabeth, Sørensen Michael
Department of Hepatology & Gastroenterology, Aarhus University Hospital, Palle Juul- Jensens Boulevard 35, Aarhus N, DK-8200, Denmark.
Department of Gastroenterology & Hepatology, Aalborg University Hospital, Mølleparkvej 4, Aalborg, DK-9000, Denmark.
EJNMMI Res. 2025 Jul 16;15(1):88. doi: 10.1186/s13550-025-01285-9.
The effect of different locoregional treatments for hepatocellular carcinoma (HCC) on metabolic liver function is largely unknown. This information is crucial, particularly for patients with cirrhosis. We applied [F]-fluoro-2-deoxy--galactose (F-FDGal) positron emission tomography (PET) to determine the contribution of large HCCs to total metabolic liver function and the changes in metabolic liver function post-treatment.
We included 29 patients with HCC treated with resection ( = 8), radiofrequency ablation (RFA) ( = 8), transarterial chemoembolization (TACE) ( = 9), and selective internal radiation therapy (SIRT) ( = 4). In patients with HCCs > 3 cm, the liver’s total metabolic activity was significantly higher when including the metabolically active tumor areas compared to when the tumor was excluded ( = 0.0002). The median percent change in mean metabolic activity in the liver after locoregional treatment was 5.1% in patients without cirrhosis as compared to -6.0% in patients with cirrhosis ( = 0.05). The distribution of cirrhosis ( = 15 in total) among treatment groups was uneven. After treatment, seven of eight patients who underwent resection showed increased or stable mean metabolic liver function, while responses for those treated with RFA, TACE, or SIRT were mixed. Changes in mean metabolic liver function and liver volume did not correlate.
HCCs > 3 cm contributed substantially to the liver’s galactose metabolism, suggesting that this would also apply to other substrates used for measuring metabolic liver function. Changes in metabolic capacity following treatment depend on cirrhosis status and type of treatment. Changes in functional liver volume do not necessarily reflect total metabolic capacity. The study underlines the power of imaging-based quantification of metabolic liver function.
The online version contains supplementary material available at 10.1186/s13550-025-01285-9.
不同局部区域治疗对肝细胞癌（HCC）代谢性肝功能的影响在很大程度上尚不清楚。这些信息至关重要，尤其是对于肝硬化患者。我们应用[F]-氟-2-脱氧-D-半乳糖（F-FDGal）正电子发射断层扫描（PET）来确定大肝癌对肝脏总代谢功能的贡献以及治疗后代谢性肝功能的变化。
我们纳入了29例接受手术切除（n = 8）、射频消融（RFA）（n = 8）、经动脉化疗栓塞（TACE）（n = 9）和选择性内放射治疗（SIRT）（n = 4）的HCC患者。在肿瘤直径>3 cm的HCC患者中，与排除代谢活跃的肿瘤区域相比，纳入这些区域时肝脏的总代谢活性显著更高（P = 0.0002）。局部区域治疗后，无肝硬化患者肝脏平均代谢活性的中位百分比变化为5.1%，而肝硬化患者为-6.0%（P = 0.05）。治疗组间肝硬化患者的分布（总共15例）不均衡。治疗后，8例接受手术切除的患者中有7例肝脏平均代谢功能增加或稳定，而接受RFA、TACE或SIRT治疗的患者反应不一。肝脏平均代谢功能的变化与肝脏体积的变化无相关性。
直径>3 cm的HCC对肝脏半乳糖代谢有显著贡献，这表明这也适用于用于测量代谢性肝功能的其他底物。治疗后代谢能力的变化取决于肝硬化状态和治疗类型。功能性肝体积的变化不一定反映总代谢能力。该研究强调了基于成像的代谢性肝功能定量分析的作用。
在线版本包含可在10.1186/s13550-025-01285-9获取的补充材料。
